Comorbid personality disorders in subjects with panic disorder: which personality disorders increase clinical severity?

Personality disorders are common in subjects with panic disorder. Personality disorders have shown to affect the course of panic disorder. The purpose of this study was to examine which personality disorders effect clinical severity in subjects with panic disorder. This study included 122 adults (71 female, 41 male), who met DSM-IV criteria for panic disorder (with or without agoraphobia). Clinical assessment was conducted by using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II) and the Panic and Agoraphobia Scale (PAS), Global Assessment Functioning Scale (GAF), Beck Depression Inventory (BDI), and State-Trait Anxiety Inventory (STAI). Patients who had a history of sexual abuse were assessed with Sexual Abuse Severity Scale. Logistic regressions were used to identify predictors of suicide attempts, suicidal ideation, agoraphobia, different panic attack symptoms, sexual abuse, and early onset of disorders. The rates of comorbid Axis I and Axis II psychiatric disorders were 80.3% and 33.9%, consecutively, in patients with panic disorder. Panic disorder patients with comorbid personality disorders had more severe anxiety, depression and agoraphobia symptoms, and had earlier ages of onset, and lower levels of functioning. The rates of suicidal ideation and suicide attempts were 34.8% and 9.8%, consecutively, in subjects with panic disorder. The rate of patients with panic disorder had a history of childhood sexual abuse was 12.5%. The predictor of sexual abuse was more than one comorbid Axis II diagnosis. The predictors of suicide attempt were comorbid paranoid and borderline personality disorders, and the predictor of suicidal ideation was major depressive disorder in subjects with panic disorder. In conclusion, this study documents that comorbid personality disorders increase the clinical severity of panic disorder. Patients with more than one comorbid Axis II diagnosis had more severe clinical symptoms. Borderline, Cluster B and -with a lower effect- Cluster C personality disorders seem to increase the clinical severity of panic disorder

Neuroleptic malignant syndrome in two brothers with mental retardation

Antipsychotic drugs have been widely used in patients with mentalretardation. Neuroleptic malignant syndrome (NMS) is a life-threatening condition associated with dopaminergic blockage.Mentally retarded patients using intramuscular antipsychoticinjections have a significantly higher risk of developing NMS. In thispaper, NMS is reported in two brothers (ages 20 and 29) with mentalretardation. Both cases had clinical manifestations of NMS includingmuscle rigidity, hyperprexia, tremor, altered mental status, acuterenal failure, elevated creatinine phosphokinase levels andautonomic instability after 3 weeks of haloperidol treatment.Haloperidol was discontinued in both patients and supportivetreatment and bromocriptine was initiated. Clonazepam was alsostarted in one of the patients. While the younger patient who usedclonazepam was discharged from the hospital 20 days later, theolder one died due to cardiovascular collaps

Effect of electroconvulsive therapy on oxidative metabolism in major depressive disorder

WOS: 000414860000016Purpose: Electroconvulsive therapy (ECT) has been shown to be effective for major depressive disorder. This study aimed to evaluate the association between ECT and the effects of ECT on total antioxidant level, total oxidant level, oxidative stress index in major depression. Material and Methods: The study group consisted of 23 inpatients with major depressive disorder defined by DSM-IV criteria and 22 healty volunteers. Socio-demographic and clinical information were collected using structured questionnaire. Venous blood samples were taken from patients and controls. The biochemical parameters analyzed were serum total antioxidant level, total oxidant level. Results: Total antioxidant level was lower in the major depressive disorder group compared with those of the controls before ECT. Total antioxidant levels were significantly increased with electrocunvulsive therapy in patient group. There was no significant difference for total antioxidant levels after ECT. There was no significant difference between patient and control groups in terms of total oxidant level and oxidative stress index before and after ECT. Conclusion: The results suggest that ECT leads to an increase in antioxidant levels in patients with major depressive disorder

Serum Galectin‐1, Galectin‐9, and YKL‐40 levels in bipolar disorder and their relationship with cognitive functions

Abstract Purpose The number of studies conducted on the role of neuroinflammation in the etiopathogenesis of bipolar disorder has been increasing in recent years. The role of Galectin‐1, Galectin‐9, and YKL‐40, which are considered to play roles in neuroinflammation and the etiopathogenesis of bipolar disorder, and the relationship of these parameters with cognitive functions were investigated in the present study. Method Serum Galectin‐1, Galectin‐9, and YKL‐40 levels were measured with the ELISA Method in 64 bipolar euthymic patients and 64 healthy controls. The Stroop and trail‐making tests were administered to assess cognitive functions in all participants. Results Serum Galectin‐1, Galectin‐9, and YKL‐40 levels were statistically and significantly lower in the patient group when compared to the healthy control group. The scores of the Stroop test and trail‐making tests were statistically higher in the patient group than in the healthy control group. There was a weak and positive correlation between serum Galectin‐1, Galectin‐9, and YKL‐40 levels and cognitive performance in all participants. Discussion and conclusion Statistically significant low levels of serum Galectin‐1, Galectin‐9, and YKL‐40 detected in the patient group suggest that these parameters have important roles in neuroinflammation. The statistically higher Stroop and trail‐making test scores of the patient group compared to the control group indicates that the cognitive performance of the patient group was weaker. Also, the positive correlation between Galectin‐1, Galectin‐9, and YKL‐40 levels and cognitive performance suggests that these molecules may have a neuroprotective role. We think that the present study will contribute to this field where there is very limited data in the literature

Identified predictors and levels of burnout among staff workers in a refugee camp of first immigrant group: A cross-sectional study

Essential workers in a refugee camp are exposed to many stressors that influence their ability to perform their duties. This study aims to investigate the relationship between burnout and job satisfaction, depression, anxiety, and socio-demographic variables among staff workers in a refugee camp in Turkey. The Maslach Burnout Inventory, which assesses emotional exhaustion, depersonalization and personal accomplishment, Minnesota Satisfaction Questionnaire, Beck Depression Inventory, Beck Anxiety Inventory, and socio-demographic variable form was administered to 199 staff workers in refugee camps in Turkey. High-risk levels were found to be 40.2% in emotional exhaustion, which is considered the center of burnout. Female gender, working in the camp (>12 months), low extrinsic satisfaction, and high anxiety and depression levels predicted the emotional exhaustion. While low intrinsic satisfaction, high depression levels, and working in the camp (>12 months) were found to be predictors for depersonalization, low intrinsic satisfaction was determined to be a predictor for reduced personal accomplishment. It was determined that burnout was high among the personnel working in the refugee camps and the factors that played a role in its development were female gender, working in the camp (>12 months), low extrinsic satisfaction, high anxiety and depression levels, and low intrinsic satisfaction. It is recommended that these personnel be evaluated first, improving their working conditions, and providing psychosocial support. [Med-Science 2022; 11(1.000): 135-41

Oxidative metabolism may be associated with negative symptoms in schizophrenia

Objective: In the present study, we aimed to examine the relationship between the oxidative metabolism with disease severity, sociodemographic, and clinical characteristics in the patients with schizophrenia. Methods: Seventy-one patients with schizophrenia and 76 healthy volunteers were included in the study. Plasma total antioxidant level (TAL) and total oxidant level (TOL) were analyzed, and oxidative stress index (OSI) was calculated. Results: There was a statistically significant increase in TOL and OSI and decrease in TAL in the patients with schizophrenia compared to the controls (p < .05). There were positive, mild, statistically significant correlations between TOL, OSI, and Positive and Negative Syndrome Scale-Total scores (p = .01, p = .01, respectively), Positive and Negative Syndrome Scale-Negative scores (p = .002, p = .001, respectively), Positive and Negative Syndrome Scale Global Psychopathology scores (p = .03, p = .03, respectively), and Clinical Global Impression-Severity Scale scores (p = .008, p = .009 respectively). OSI levels were significantly lower in the patients who were on treatment with atypical antipsychotics (AAP) compared to the patients who were on typical antipsychotics (TAP) and combined antipsychotic (CAP) agents (p = .032). Conclusions: Oxidative stress was higher in schizophrenia patients. The increased severity of negative symptoms was in line with the disruption in oxidative balance. Oxidative stress is quite lower in AAP users compared to the TAP and CAP users. One of the mechanisms underlying the fact that AAPs are more effective on negative symptoms than typical agents may be the positive effect on the oxidative stress